Workers’ Compensation Defense / Temporary Total Disability – Florida
The First District Court of Appeal issued a decision on February 28, 2013 in Westphal v. City of St. Petersburg/City of St. Petersburg Risk Management & State of Florida, holding the limitation of 104 weeks for temporary total disability benefits (TTD) was unconstitutional.  The case addresses the “gap” of time between the expiration of 104 weeks of entitlement to temporary total disability benefits and the actual date of overall maximum medical improvement (MMI) from all relevant medical standpoints.  Specifically, the court addressed whether a claimant is entitled to additional TTD benefits in excess of 104 weeks if he/she is not medically at MMI at the expiration of the 104 weeks and remains unable to return to work.

The Court determined that the old provision of 260 weeks of TTD that applied under the 1991 statute is now in effect.  To reach its conclusion, the Court focused on the concept of “natural justice” and cited for its authority the 1917 case of N. Y. Central Rd. Co. vs. White, 243 U. S. 188, 202 (1917).  The overall ruling seems to imply that while there have been limitations in the past on benefits paid to injured workers, allowing 260 weeks is more representative of “natural justice” than limiting severely injured claimants to only 104 weeks of entitlement to TTD benefits.  In its analysis, the Court made comparisons to other states’ workers’ compensation laws, such as Georgia, Alabama, Louisiana and the Carolinas, and it found Florida’s limitation of 104 weeks to be an inadequate and unreasonable alternative to the right afforded under tort law, or the pre-1994 version of the workers’ compensation statute.

Although the ruling cites the case of Kluger v. White, 281 So. 2d 1 (Fla. 1973) for the proposition that the Legislature must provide a reasonable alternative when limiting substantive rights of the people otherwise available under the common law, the Court seems to have overlooked the legislative findings written over 20 years ago when the provision allowing 104 weeks of entitlement was taken from the Texas law.

While ruling that a Claimant is entitled to 260 weeks of TTD benefits, the Court, however, left standing the provision allowing 104 combined weeks of entitlement to temporary partial disability (TPD) benefits.  The Court focused on the seriousness of the injury at issue and it left unclear how the TPD provisions of the statute would be handled, or whether their reasoning would also apply to TPD benefits.  Some may assume that the Court intended to increase TPD benefits to a whole of 104 weeks, in addition to a total of 260 weeks of TTD benefits.  Clearly, entitlement to TPD benefits has a different standard for awarding benefits than TTD benefits awards.

The Westphal holding appears to limit the 260 weeks to the provision of TTD benefits and would not apply to TPD benefits.  Nonetheless, we can certainly anticipate that the Claimant’s bar may argue that application of this ruling to any pending TPD benefits awards should follow, especially if the statutes are interpreted side by side.

Significantly, the Westphal ruling also specified that the opinion “shall have prospective application only, and shall not apply to rulings, adjudications, or proceedings that have become final prior to the date of this opinion.”  It is unclear why the Court added the above defining language.  For practical purposes, this case is not yet final until the period to challenge the opinion expires.  The parties have 15 days from the date of the opinion to file a Motion for Rehearing and/or seek a rehearing en banc before the entire appellate court.

Alternatively, if the parties decide to do so, an appeal to the Florida Supreme Court would place a stay on pending proceedings.  The Florida Supreme Court would not be limited to the questions presented to the 1st DCA and, if the high court decides to review this case under its discretionary or mandatory jurisdiction, it may seize the opportunity to address the constitutional issues of access to courts, equal protection, and denial of due process under other areas of Chapter 440.

We are closely watching this case and will update our clients as soon as we know the decision as to the next procedural steps.  Additionally, members of this firm are currently working with the Business and Insurance Workers’ Compensation Committee in Tallahassee to address legislative responses to this recent ruling.

While this case is resolved at the appellate level, we would encourage you to be particularly mindful of any case you are handling wherein the claimant might be reaching the 104 weeks of temporary indemnity benefits and seek legal advice as to how it should be handled in the event the case of Westphal becomes final.

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